Largest Ketamine Study Ever Finds it Fights Depression

A huge study of patients who were given drugs to relief pain found ketamine to be strikingly effective.(Cohen, Makunts, Atayee, & Abagyan, 2017)

Those who took ketamine reported symptoms of depression 50% less frequently than patients given any other combination of drugs for pain.(1)

Ketamine Found Effective for Treating Depression and Pain

Now, in the largest study of its kind, researchers found that “this reduction in depression is specific to ketamine and is known to be much more rapid than current antidepressants, making this observed effect very promising for the treatment of patients with acute depressive or suicidal episodes.”

First Large-Scale Study of Ketamine for Depression

While previous studies have found ketamine to be effective in treating depression, they have all been small-scale investigations. Ketamine has been around for over 50 years and thus has been a generic drug for decades.

As a result, pharmaceutical companies can’t make money off the drug, and large-scale studies to study its effectiveness in fighting depression have been too costly to undertake.

However, researchers came up with an ingenious way to conduct a large-scale study of ketamine at a fraction of the cost.

They examined over 8 million patient records in the FDA Adverse Effect Reporting System (FAERS). This system was created to track the frequency of the adverse effects of drugs, but using statical analysis it can also provide insight into the benefits of drugs.

The database included 41,000 patients who took ketamine. They then compared those who took ketamine for pain management with those who took other pain medications and found the patients who had received ketamine exhibited significantly reduced rates of depression.

Ketamine for Pain Management

In addition to treating depression, ketamine is increasingly being used for pain management. Researchers found support for this trend as patients who received ketamine achieved significant pain relief.

Further support for ketamine as an adjunct therapy for pain was that these patients were less likely to report common side effects such as constipation, vomiting, and nausea than patients who received any other combination of drugs for pain.

Ketamine Therapy Available Now

Ketamine is currently being used by physicians to offer relief to their patients from depression and pain.

The researchers behind this study make a strikingly forceful argument on behalf of the use of ketamine for these conditions.

The results of this study support previous small-scale studies’ conclusions that ketamine is a good monotherapy or adjunct therapy for depression. In clinical practice, ketamine would be especially useful for depression because of the quick onset of its action compared to existing first line therapies. Regardless of the causative mechanism ketamine appears to have therapeutic potential for TRD. Further, the potential to reduce many of the most complained side effects of opioid treatment makes ketamine adjunct therapy for pain seem desirable.

Holy Grail: FDA Approval for Ketamine Therapy

Ketamine was approved as an anesthetic by the FDA decades ago. It is used off-label by an increasing number of clinicians for the treatment of depression and pain.

Insurance won’t usually pay for the off-label use of drugs, but if the FDA were to say that ketamine therapy is effective for these conditions then insurance companies would likely be required to pay for treatment. In the past, FDA approval has seen as unlikely to happen as it would require a large-scale study.

But as these researchers noted, “this study also outlines a methodology for discovering off-label pharmacology of existing approved drugs. This method can be applied to other indications and may reveal new important uses of already approved drugs, providing reliable justification for new indications without large investments in additional clinical trials.”

Dr. Steven Mandel, of the Ketamine Clinics of Los Angeles, was guardingly optimistic, “This may be a route to getting the FDA to consider endorsing ketamine for this indication.”(2)

Such support by the FDA could bring welcome relief to millions who are not being served by the current class of anti-depressants available to most patients. “Current FDA-approved treatments for depression fail for millions of people because they don’t work or don’t work fast enough,” said senior author Ruben Abagyan, PhD, professor of pharmacy.(3)